Drug Guide
Gallium Nitrate
Classification
Therapeutic: Antineoplastic agent, Hypercalcemia of malignancy treatment
Pharmacological: Gallium compound, Metal compound
FDA Approved Indications
- Hypercalcemia of malignancy refractory to hydration and bisphosphonates
Mechanism of Action
Gallium nitrate inhibits osteoclast-mediated bone resorption and has antitumor activity, possibly through interference with the tumor cell metabolism and immune modulation.
Dosage and Administration
Adult: 25 mg/m2 IV over 30 minutes, repeated every 3–4 weeks as needed
Pediatric: Not typically used in pediatric population
Geriatric: Adjust dose based on renal function, similar to adults
Renal Impairment: Reduced doses may be necessary based on renal function; monitor renal parameters closely
Hepatic Impairment: No specific adjustment known
Pharmacokinetics
Absorption: Not applicable; administered IV
Distribution: Widely distributed, including bone and soft tissues
Metabolism: Not extensively metabolized
Excretion: Primarily renal excretion
Half Life: Approximately 5–7 days, prolonged in renal impairment
Contraindications
- Known hypersensitivity to gallium nitrate or components
Precautions
- Renal impairment—use with caution; monitor renal function closely
- Electrolyte imbalances—correct prior to therapy
- Infusion reactions—monitor during administration
Adverse Reactions - Common
- Nausea (Common)
- Vomiting (Common)
- Flushing (Common)
- Nephrotoxicity (Potentially serious)
- Electrolyte disturbances (hypokalemia, hypomagnesemia) (Common)
Adverse Reactions - Serious
- Renal failure (Serious)
- Arrhythmias related to electrolyte abnormalities (Serious)
- Myelosuppression (Potentially serious)
Drug-Drug Interactions
- Nephrotoxic drugs (e.g., aminoglycosides, amphotericin B)
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor renal function (BUN, serum creatinine), electrolytes, and complete blood count before and during therapy.
Diagnoses:
- Risk for renal impairment
- Electrolyte imbalance
Implementation: Administer IV infusion over 30 minutes as prescribed. Hydrate the patient adequately before administration.
Evaluation: Assess for signs of hypocalcemia, electrolyte disturbances, and renal function deterioration.
Patient/Family Teaching
- Report any symptoms of kidney problems (e.g., decreased urine output, swelling).
- Maintain hydration and follow dietary recommendations.
- Inform about potential side effects, including flushing and gastrointestinal discomfort.
Special Considerations
Black Box Warnings:
- Renal toxicity—use caution and monitor renal function closely
Genetic Factors: None specific
Lab Test Interference: May cause transient increases in serum calcium; interpret labs accordingly.
Overdose Management
Signs/Symptoms: Severe hypocalcemia, renal failure, electrolyte disturbances
Treatment: Discontinue gallium nitrate, provide supportive care, correct electrolytes, maintain hydration, and consider dialysis if necessary.
Storage and Handling
Storage: Store at room temperature, protected from light
Stability: Stable under recommended conditions, discard unused portion after expiration or if particulate matter or discoloration occurs.